Home Occupancy Application

Business Status

What would you like to do today:

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New Application

Is this a:

None of the above

Business Name and Physical Location

Business Name or Trade Name	Bite and Babble Pediatric Feeding and Speech Therapy LLC
Business Street Address (Physical location of the business cannot be a PO Box)	---
Mailing Address (Street name and number only)	---
Mailing Address City, State, & Zip Code	---
Business Phone Number	+19282778555
Number of Employees	---
Please read trough the list carefully and select the closest description of your business:	HEALTH SERVICES
Business Description (Please describe in detail the nature of the business)	---
Start of business date	2023-07-25
is the business location:	---
Nature of Ownership	---

LLC Ownership Information

State in which the LLC was legally established	---
1. Name of Owner (First and Last)	---
Title	---
Home Street Address of Owner (cannot be a PO Box)	---
Telephone Number	---

Federal Tax ID or Social Security Number

Please provide your Federal ID or Social Security Number

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Transaction Privilege Tax (Sales Tax)

Transaction Privilege Tax (TPT) Number

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Professional Licenses

Upload File

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Applicant Information (Must be completed by the person filling out this application)

Name (First and Last)	Emma Riggs
Home Address (No PO Boxes)	---
Phone number	---
Driver's License Number	---
Driver's License Expiration Date	---
Date of Birth	---
Social Security Number (Last four (4) digits only)	---

Application Affidavit

Applicant Affidavit

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Conditional Home Occupation Permit

Will you need to apply for a Conditional Home Occupation permit?

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Prohibited Home Occupations Disclosure

I hereby declare that in the conduct of my Home Occupation at the above address, I will comply with the requirements pertaining to such occupations as set forth in the Prescott Valley Town Code mentioned above.

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Late Fee

Do they need a late fee?

No